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螺内酯治疗慢性中心性浆液性脉络膜视网膜病变患者的视觉和解剖学结果

Visual and Anatomical Outcomes of Spironolactone Therapy in Patients with Chronic Central Serous Chorioretinopathy.

作者信息

Falavarjani Khalil Ghasemi, Amirsardari Anahita, Habibi Abbas, Eshaghi Acieh, Bakhti Shohreh, Aghdam Kaveh Abri

机构信息

Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

出版信息

J Ophthalmic Vis Res. 2017 Jul-Sep;12(3):281-289. doi: 10.4103/jovr.jovr_139_16.

Abstract

PURPOSE

To evaluate the effect of spironolactone on chronic central serous chorioretinopathy (CSC).

METHODS

In this prospective interventional case series, patients with chronic CSC were treated with spironolactone (25 mg daily) for at least 6 weeks. If the subretinal fluid (SRF) had not completely resolved by this time, treatment was continued, and the dosage was increased to 25 mg twice daily. Primary outcome measure was the change in maximum SRF height at the final follow-up visit, as detected by optical coherence tomography. Secondary outcome measures were changes in best corrected visual acuity (BCVA) and central macular thickness (CMT).

RESULTS

Sixteen eyes of 14 patients with chronic CSC were enrolled. Mean follow-up time was 6.4 ± 4.3 months. Baseline BCVA was 0.54 ± 0.44 logarithm of the minimum angle of resolution (log MAR), which improved to 0.42 ± 0.43 log MAR at the final visit ( = 0.04). Mean CMT decreased from 282.69 ± 103.23 μm at baseline to 236.75 ± 90.10 μm at final visit ( = 0.11), and the mean of maximum SRF height decreased from 155.63 ± 95.27 μm at baseline to 77.19 ± 95.68 μm at the final visit ( = 0.04). SRF resolved completely in seven eyes (43.75%).

CONCLUSION

In eyes with persistent SRF due to CSC, spironolactone therapy was associated with a statistically significant decrease in maximum SRF height, as well as an improvement in BCVA.

摘要

目的

评估螺内酯对慢性中心性浆液性脉络膜视网膜病变(CSC)的疗效。

方法

在这个前瞻性干预性病例系列中,慢性CSC患者接受螺内酯治疗(每日25毫克)至少6周。如果此时视网膜下液(SRF)尚未完全消退,则继续治疗,并将剂量增加至每日两次,每次25毫克。主要结局指标是末次随访时光学相干断层扫描检测到的最大SRF高度的变化。次要结局指标是最佳矫正视力(BCVA)和中心黄斑厚度(CMT)的变化。

结果

纳入了14例慢性CSC患者的16只眼。平均随访时间为6.4±4.3个月。基线BCVA为0.54±0.44最小分辨角对数(logMAR),末次随访时提高至0.42±0.43 logMAR(P = 0.04)。平均CMT从基线时的282.69±103.23μm降至末次随访时的236.75±90.10μm(P = 0.11),最大SRF高度的平均值从基线时的155.63±95.27μm降至末次随访时的77.19±95.68μm(P = 0.04)。7只眼(43.75%)的SRF完全消退。

结论

在因CSC导致SRF持续存在的眼中,螺内酯治疗与最大SRF高度的统计学显著降低以及BCVA的改善相关。

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